@layout("/common/_container.html"){
<link href="https://pynnn.oss-cn-hangzhou.aliyuncs.com/shopcustomer.css?v=20200628" rel="stylesheet">
<div class="ibox float-e-margins">
    <div class="ibox-content">
        <div class="form-horizontal" id="customerInfoForm">
            <div style="display: none">
                <input type="hidden" id="id" value="${customerInfo.id}">
                <input type="hidden" id="provinceValue" value="">
                <input type="hidden" id="citiesValue" value="">
                <input type="hidden" id="regionValue" value="">
                <input type="hidden" id="oneChannelValue" value="${customerInfo.oneChannel}">
                <input type="hidden" id="twoChannelValue" value="${customerInfo.twoChannel}">
                <input type="hidden" id="thrChannelValue" value="${customerInfo.thrChannel}">
                <input type="hidden" id="oneMediumValue" value="${customerInfo.oneMedium}">
                <input type="hidden" id="twoMediumValue" value="${customerInfo.twoMedium}">
                <input type="hidden" id="thrMediumValue" value="${customerInfo.thrMedium}">
                <input type="hidden" id="Recommender" value="">
                <input type="hidden" id="customerSexValue" value="${customerInfo.customerSex}">
                <input type="hidden" id="fieldTcValue" value="${customerInfo.fieldTc}">
                <input type="hidden" id="treatmentUnitValue" value="${customerInfo.treatmentUnit}">
                <input type="hidden" id="appointmentPayService" value="${customerInfo.appointmentPayService}">
                <input type="hidden" id="scarchiving" value="${customerInfo.scarchiving}">
                <input type="hidden" id="phoneSharShipValue" value="${customerInfo.phoneSharShip}">
            </div>
            <div class="row">
                <div class="col-sm-12">
                    <h5>必填选项</h5>
                    <div>
                        <ul class="ulBox">
                            <li>
                                <div>
                                    <span>姓名 <span class="must">*</span></span>
                                    <input autocomplete="off" type="text" id="customerName" class="frameBox" value="${customerInfo.customerName}">
                                </div>
                                <div>
                                    <span>生日 <span class="must">*</span></span>
                                    <input autocomplete="off" type="text" id="birthday" class="frameBox" maxlength="10" value="">
                                </div>
                                <div>
                                    <span>年龄 <span class="must">*</span></span>
                                    <input autocomplete="off" type="text" id="customerAge" maxlength="2" class="frameBox"
                                           oninput="value=value.replace(/[^\d]/g,'')" value="${customerInfo.customerAge}">
                                </div>
                                <div>
                                    <span>性别 <span class="must">*</span></span>
                                    <select name="customerSex" id="customerSex" class="frameBox">
                                        <option value="1">男</option>
                                        <option value="2">女</option>
                                    </select>
                                </div>
                                <div>
                                    <span>科室 <span class="must">*</span></span>
                                    <select id="treatmentUnit" class="frameBox">
                                        <option value="待定">待定</option>
                                        @for(str in departmentList){
                                        <option value="${str.department}">${str.department}</option>
                                        @}
                                    </select>
                                </div>
                                <div>
                                    <span>分诊TC <span class="must">*</span></span>
                                    <select name="fieldTc" id="fieldTc" class="frameBox">
                                        <option value="待定TC">待定TC</option>
                                        @for(str in tcList){
                                        <option value="${str.tcName}">${str.tcName}</option>
                                        @}
                                    </select>
                                </div>
                                <div>
                                    <span>建档人 <span class="must">*</span></span>
                                    <input autocomplete="off" type="text" id="archiving" class="frameBox" value="${customerInfo.archiving}" readonly="readonly">
                                </div>
                                <div>
                                    <span>推荐人</span>
                                    <input autocomplete="off" type="text" id="referee" class="frameBox" readonly="readonly" style="width: 45%;background: #eaeae3" >
                                    <button class="btn" type="button" style="padding: 0;vertical-align: top;width: 15%;height: 28px;" onclick="CustomerInfoDlg.getReferee()">选择</button>
                                </div>
                            </li>
                            <li>
                                <div>
                                    <span>电话 <span class="must">*</span></span>
                                    <input autocomplete="off" type="text" id="customerPhone" class="frameBox" value="${customerInfo.customerPhone}" readonly="readonly" style="width: 36%">
                                    <select class="frameBox" style="width: 22%" id="phoneSharShip">
                                        @for(str in refereeShipList){
                                        <option value="${str.refereeShip}">${str.refereeShip}</option>
                                        @}
                                    </select>
                                </div>
                                <div>
                                    <span>一级渠道 <span class="must">*</span></span>
                                    <select name="oneChannel" id="oneChannel" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>二级渠道 <span class="must">*</span></span>
                                    <select name="twoChannel" id="twoChannel" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>三级渠道 <span class="must">*</span></span>
                                    <select name="thrChannel" id="thrChannel" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>一级媒介 <span class="must">*</span></span>
                                    <select name="oneMedium" id="oneMedium" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>二级媒介 <span class="must">*</span></span>
                                    <select name="twoMedium" id="twoMedium" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>三级媒介 <span class="must">*</span></span>
                                    <select name="thrMedium" id="thrMedium" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>推荐关系</span>
                                    <select name="refereeShip" id="refereeShip" class="frameBox">
                                        <option value="">--请选择与推荐人关系--</option>
                                        @for(str in refereeShipList){
                                        <option value="${str.refereeShip}">${str.refereeShip}</option>
                                        @}
                                    </select>
                                </div>
                            </li>
                            <li>
                                <div>
                                    <span>客户状态 <span class="must">*</span></span>
                                    <input autocomplete="off" type="text" id="customerStatus" disabled="disabled" class="frameBox" value="新客首次">
                                </div>
                                <div>
                                    <span>省份 <span class="must">*</span></span>
                                    <select name="province" id="province" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>城市 <span class="must">*</span></span>
                                    <select name="cities" id="cities" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>区域</span>
                                    <select name="region" id="region" class="frameBox"></select>
                                </div>
                                <div>
                                    <span>地址</span>
                                    <input autocomplete="off" type="text" id="address" class="frameBox">
                                </div>
                                <div>
                                    <span>黄页编号 <span class="must">*</span></span>
                                    <input autocomplete="off" type="text" class="frameBox" value="${customerInfo.yellowNumber}" id="yellowNumber" name="yellowNumber"  maxlength="8" oninput="value=value.replace(/[^\d]/g,'')">
                                </div>
                                <div>
                                    <span>职业</span>
                                    <select name="occupation" id="occupation" class="frameBox">
                                        <option value="其他">其他</option>
                                        @for(str in occupationList){
                                        <option value="${str.occupation}">${str.occupation}</option>
                                        @}
                                    </select>
                                </div>
                            </li>
                        </ul>
                    </div>
                </div>
                <div class="col-sm-12">
                    <h5>选填选项</h5>
                    <div>
                        <ul class="ulBox">
                            <li>
                                <div>
                                    <span>消费能力</span>
                                    <select name="consumAbility" id="consumAbility" class="frameBox">
                                        <option value="">--请选择消费能力--</option>
                                        @for(str in consumAbilityList){
                                        <option value="${str.consumAbility}">${str.consumAbility}</option>
                                        @}
                                    </select>
                                </div>
                                <div>
                                    <span>消费习惯</span>
                                    <select name="consumptionHabits" id="consumptionHabits" class="frameBox">
                                        <option value="">--请选择消费习惯--</option>
                                        @for(str in consumptionHabitsList){
                                        <option value="${str.consumptionHabits}">${str.consumptionHabits}</option>
                                        @}
                                    </select>
                                </div>
                                <div>
                                    <span>身份证</span>
                                    <input autocomplete="off" type="text" id="idCardNo" class="frameBox">
                                </div>
                                <div>
                                    <span>座机</span>
                                    <input autocomplete="off" type="text" id="fixedTelephone" class="frameBox" oninput="value=value.replace(/[^\d]/g,'')">
                                </div>
                            </li>
                            <li>
                                <div>
                                    <span>QQ号</span>
                                    <input autocomplete="off" type="text" id="qqNumber" class="frameBox" oninput="value=value.replace(/[^\d]/g,'')">
                                </div>
                                <div>
                                    <span>微信号</span>
                                    <input autocomplete="off" type="text" id="wechatNumber" class="frameBox">
                                </div>
                                <div>
                                    <span>Email</span>
                                    <input autocomplete="off" type="text" id="email" class="frameBox">
                                </div>
                                <div>
                                    <span>邮编</span>
                                    <input autocomplete="off" type="text" id="zipCode" class="frameBox" oninput="value=value.replace(/[^\d]/g,'')">
                                </div>
                            </li>
                            <li>
                                <div>
                                    <span>婚姻状况</span>
                                    <select name="maritalStatus" id="maritalStatus" class="frameBox">
                                        <option value="0">请选择</option>
                                        <option value="1">已婚</option>
                                        <option value="2">未婚</option>
                                        <option value="3">离异</option>
                                    </select>
                                </div>
                                <div>
                                    <span>有无小孩</span>
                                    <select name="isHaveChildren" id="isHaveChildren" class="frameBox">
                                        <option value="0">请选择</option>
                                        <option value="1">有</option>
                                        <option value="2">无</option>
                                    </select>
                                </div>
                                <div>
                                    <span>性格</span>
                                    <select name="characters" id="characters" class="frameBox">
                                        <option value="">--请选择性格--</option>
                                        @for(str in charactersList){
                                        <option value="${str.characters}">${str.characters}</option>
                                        @}
                                    </select>
                                </div>
                            </li>
                        </ul>
                    </div>
                </div>
                <div class="col-sm-12">
                    <div>
                        <h3>备注</h3>
                        <textarea id="remarks" name="remarks" rows=5 cols=150></textarea>
                    </div>
                </div>
                <div class="col-sm-12">
                    <div class="btnBox">
                        <button type="button" class="btn" id="ensure" onclick="CustomerInfoDlg.addTemporaryCustomerOK()">提交</button>
                        <button type="button" class="btn" id="cancel" onclick="parent.layer.close(parent.layer.getFrameIndex(window.name))" style="background: #999999">取消
                        </button>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<script src="https://pynnn.oss-cn-hangzhou.aliyuncs.com/jsAddresss.js?v=20200628"></script>
<script src="https://pynnn.oss-cn-hangzhou.aliyuncs.com/jsChannel.js?v=20200628"></script>
<script src="https://pynnn.oss-cn-hangzhou.aliyuncs.com/jsMedium.js?v=20200628"></script>
<script src="${ctxPath}/static/modular/arrival/customer/customer_receptionFive.js?v=20200628"></script>
<script src="${ctxPath}/static/modular/arrival/customer/customer_info.js?v=20200628"></script>
@}